Join me as I half-ass my way through medical school, encountering all sorts of freaks (patients, classmates, myself, etc.) along the way

Tuesday, September 20, 2005

Tits & Ass

Now that I have your attention, I'd like to discuss a side of surgery that often goes unnoticed, but as I have recently discovered, takes up a big chunk of time on a surgery rotation. (Don't worry, T&A will actually be discussed shortly. Pervert.) No, I don't mean OR time, hospital wards time, or even, dare I say it, Hammer Time. Sorry, that was terrible. I'm referring to clinic time, that endless struggle where general internists are banished for eternity but surgeons only visit intermittently, where patients file in and out of exam rooms (often utterly clueless as to why they are there, which I find utterly mind-blowing...more on this some other time) to be thoroughly examined, considered for potential surgery, or checked post-operatively to make sure everything has gone as planned.

However, as I have quickly learned, not all clinics are created equal. For example, my general surgery rotation consists of many specific types of clinics, each with its own character, flavor, and uniquely horrific odor. There's vascular clinic (gangrenous foot odor), pre-op clinic (straight poo), general surgery clinic (a pouperri of rectal abscess with colostomy bag undigested poo), and so on. Today consisted of eight solid hours of two very special clinics, so special that I wanted to devote a little time to each and share what I have learned:

Proctology Clinic

Yes, there really is a clinic with this name, and yes, I have to be there. Having previously examined the role the rectum has played in my life (both here and there), I would instead like to share some of the pathology I have discovered in this delightful clinic, which, if nothing else, should at least convince some of you pre-meds out there that there are better ways to spend your life instead of being, quite literally, elbow-deep in shit. To begin, I should point out that if doing digital rectal exams (DREs) were all this clinic was about, it wouldn't be that big a deal. After all, I've developed so much as a fake doctor over the last two months that, when confronted by another medical student on my team who was in disbelief that I had gone and done a DRE on the first patient I saw without any initial suggestion by a superior to do so, I responded, quite poetically, "Ya dude, you just gotta jump right in, embrace the anus." Surely, these are words to live by. I even said that with a straight face. ("Embrace The Anus" t-shirts anyone?)

Anyways, proctology clinic is far more painful than that, because this clinic is concerned less with what's deep inside the butthole (colon, prostate, etc.) than with what is immediately inside and outside the anus (hemorrhoids, abscesses, fistulas, fissures, leprechauns, spare change, and banana residue). To top things off, in order to examine this area more completely than with visual and tactile inspection alone, some twisted genuis has developed the anoscope (I'm not sure what's funnier/more pathetic: this website, the fact that this and not any real medical site was the only place where I could find a picture of this real medical device, or the fact that my mom is going to freak when she finds out I've been frequenting anal fetish websites...Hi Mom!). This device allows the trained medical professional to not only see all of the lovely anal ridges, folds, and associated pathology in and around the rectum, but also allows us to visualize what you ate for dinner yesterday, the brand of corn you bought at Safeway last week, and, for some patients who make their way through this clinic, your current condom preferences. Needless to say, in proctology clinic time flies by faster than you can say "Did hereally stick a gerbil up there?". In fact, the only thing more fun than getting to do anoscopies five times this morning was getting to do a final one on a woman with a rectal prolapse, meaning the inside of her ass had fallen out and was literally hanging on the outside. (Note: the link for the rectal prolapse is to a picture that is not for the faint of heart...that is, if you're a pussy.) And that's about all I have to say about that.

Breast Clinic

In this clinic, I have not only learned a vast amount about breast pathology (what, you were expecting me to say someting like "I JUST TOUCHED SOME TITTIES!"? I guess it's not that much of a stretch.), I have also learned a valuable lesson about lowering one's expectations whenever possible. While there is nothing inherently sexual about any medical or clinical exam (while I cannot remember which post this is in, I know I have previously commented on the nature of this idea as it relates to the pelvic exam), I'm not going to pretend that me or any other guy sent to work at a breast clinic isn't always hoping and praying that the next patient who walks in the exam room has breasts that resemble the breasts attached to Lindsay Lohan (ok, well, at least before she became anorexic) much more so than the breasts attached to her great-grandmother Mildred. Shockingly, this dream has yet to be realized. However, I have had the chance to examine many an older woman's breasts in this clinic and have come to a conclusion that will startle and disappoint Breast Men* everywhere, even potentially shaking this nation's moral fabric and the foundation of years of marketing research: Massive breasts may not be as spectacular as they are currently valued to be in today's society**.

OK, Breast Men, breath.

So why is that? Well, the obvious answer, one universally known, is gravity***. I've already had the pleasure of examining some older large chested women whose breasts are closer to their knees than their feet are, and let me tell you, no bra, stool, or forklift will make those things get to where they are supposed to be.

Yet, a more important second factor comes into play, one that may not be initially obvious to the amateur breast inspector. What you may not know is that, at least for county hospital patients who have often not been informed of the latest breakthroughs in personal hygiene, the bigger the breast, the bigger the fold between breast and abdomen, which means the more potential space there is for any number of foreign objects, bacteria, mold, or any other atrocious thing to fester in between this area for days, months, and even years at a time. You think I'm joking? You are mistaken, my friend, because I bear witness to many of the horrors I have just described, and let me tell you, it ain't pretty. Does this mean that smaller breasts are better than bigger breasts, going against conventional wisdom and pornographic standards that reach back decades, if not millenia? Tough question, one that I'd feel more comfortable opening up for comments rather than deciding on my own. Also, given my current boob-free status, I'm not about to alienate any ladies out there who haven't already been offended by the nonense I write here and suggest a personal preference one way or the other. I'll only add that when it comes down to it, boobs...umm...boobs are boobs.

Please feel free to take a moment to digest this intellectually complex postulate.

While I am tempted to end this post with that profound statement, I feel obligated to mention that in both these clinics, we can do a lot of things to really help people with their problems, however small they may appear to those of us used to doing (or, in my case, observing from afar) complex surgeries involving life and death. I'm talking about quality of life problems that may not seem as fancy as open-heart surgery, but if you've ever had these problems, they can be very big to you: reassuring women that the breast masses they feel are absolutely not cancer, removing irritating hemorrhoids, and so on. Blah blah blah helping people blah blah whatever. You get the picture.

I think I've rambled on enough, but I hope you enjoyed this glimpse into the world of the surgical clinic. Feel free to resume your lives, your breast hygeine, and your self-exploration with the extra long, rigid anoscope you just ordered from ExtremeRestraints.com.

*It is a universal truth that all men can be classified into one of three groups: Breast Man, Ass Man, or Legs Man. This is a fact. The only other acceptable category known to prowl the wild and select bars is I'll Take What I Can Get Man. And, I'm sorry, but you guys out there who claim to be Eyes Man ("The most important physical feature I look for in a woman are definitely her eyes.")...stop lying already. Nobody believes you.

**Of course, this assumes you plan on spending more than one night with these breasts, like in some sort of longterm relationship, or at least a few casual hookups spread out over the course of some amount of years. This may not apply to some or all of you, but as someone who does not adhere to the one-night-only school of relationships, I regretfully suggest that this applies to me. Excuse me for a moment while I reconsider my values.

***Actually, I have nothing worth adding here. I just don't remember ever seeing a triple star footnote marker anywhere before, and I thought I'd be a trendsetter. But if you're interested in learning more about gravity as it relates to breasts, or other obscure breast topics, I highly recommend this public service announcement.

26 Comments:

Anonymous said...

gross but quite interesting. as a female of a um proportional (slightly larger than average) chest, i don't feel offended at all. i love the web and posting anonymously..haha what u just said kinda makes me think and freaks me out a little because i'm in my 20s now but i totally dread the days when i turn like 70 or something and i know they'll be all droopy and gross and i'll wish i had a smaller chest then.. oh fake doctor, is there anything us bigger chested women can do like exercises or anything to prevent that sagging effect? or perhaps we should get a breast reduction or someting..when we turn 70ish..is that healthy?

just to help u out a bit, don't get ur hopes up for more women like that in the future Sorry! haha becuase if u think about it statistically, any woman in her 20s would never goto a breast clinic because they're breasts are healthy and fine! =) and if they did, i don't know any woman in her right mind who would let someone around her age examine her breasts and still believe its strictly professional lol i think that only happens in umm certain types of adult movies.

ah since this is anonymous i hope i'm not being a jerk when i'd like to share these insights and fun facts of "growing up with a slightly larger chest" so the men out there know how we feel too:

-i'm not making this up, totally serious and some girls might be able to verify this, sometimes when i eat a lot, the weight goes directly to my chest first giving it a swelled look. i think it happens for a few girls because it happened for my roommate too then when we lose weight it goes down less swelled (at most 1 bra size) (can the same be said of a chest implant? lol)

-did u know that not all bra sizes are the same? it depends on the store, for example mostly i'm a size D (just to get the curiousity out, not terribly big but pretty good for an asian girl (sorry not Jewish obviously otherwise i wouldn't be making such a crazy post)) but like a size D at say victoria's secret can be a size C at another store say..JC pennys and a size B somewhere else, it depends on the brand

-shopping can be a chore becuase i used to believe that there was a consipiracy to make the chest area smaller in most clothes before i realized umm mine were slightly bigger (i didn't realize that until someone told me) anyway that brings an issue for us girls because either we have to order a dress 7 sizes bigger and take it in for the chest to fit well or sometimes i just take out the padding in my dresses and my friend said something about a bra and i was like (uh oh i should umm go wear one), instead i opted for sticker bras which take less space

-obviously everyone knows umm staring is rude, but growing up, i get rude stuff from boys BUT did u know girls tease a lot too? my girl friends when we go clothes shopping are always making good natured jokes about how "giant-normous" my body part is or saying things like "you're look too boobilicious, try this (smaller outfit that covers it up)" yes we actively try to cover it up and minimize the chest to draw less attention. did u know man created a fantastic invention called the "minimizer" bra which makes the chest look smaller? thank goodness!its kind of a peeve when guys ask me sometimes if i've gotten implants, but actually girls ask that too so i guess it makes guys seem more human when u think about it.. my girl friends laugh at me all the time and say "say u should get implants (sarcastically)"

-growing up, i never felt offended at "barbie" or those umm like for exampe playboy mags (other adult mags totall gross me out becuase of the thinigs women do in there) when i looked that them, i feel sympathy for them, they look just like normal women to me, and i understand how they feel about being different when being born with a bigger chest can't be helped. :: sniff sniff: anyway, sometimes i wish men and women in general would be kinder to women with huge chests but esp the women becuase women, i mean we're supposed to be sisterly and stuff, not be jealous the women who look a litte different, truthfully it hurts more when women are not as nice to each other..and thats all i have to say about that..

-on a last note, i must say i posted some stuff of umm colorful nature up here but this being the web and totally anonymous, i just wanted to point out that i enjoy embarrassing people haha but i just wanted to share a main point that women with huge chests are quite human too sometimes we wish we had smaller because we worry if the guy really likes us for us.. sometimes i envy my girl friends with normal average chests because i feel like they don't have the pressure and they feel more secure in themselves... plus i really enjoy reading this post weekly, and you doctors work so hard, i felt u guys deserved some insight to the world of some women with big chests. LoL the end (feel free to delete edit this entry to umm the proper audience hehe)

Being a REAL ER nurse, male type, I'm the usual suspect for anything remotely approaching gross with male patients who present with (1. ANY kind of urinary/sexual/below the belt complaint and (2. male butts.Things jammed IN and around male butts, including abscesses and other gross things. Over the years, I have grown immune to the stories that accompany the complaints. ("Lessee if I have this right. You were painting the ceiling nude because you didnt want to get any paint on your clothes. You fell off the ladder onto the couch backwards where this spatula you had from making dinner was. Ok. It's your party, pal.") I have finally come up with the absolute totally perfect survival tool, which I shall entitle "The Three CRITICAL Things an ER Nurse needs to Know." They are:1. Never let the patient get between you and the door. It doesn't matter that I'm 5'11" and 250 pounds.They will try and hurt you at some point.2. Buy a long stethoscope so you don't have to stand REAL close to them. Long enough, but not so long you swing it and hit your balls. 3. If it's REALLY REALLY gross, cover it quick with a bandage and let the doc deal with it.

So are you really thinking about how gross everything is when you do an exam? Think hard, because what you say will have a bearing on whether or not I feel comfortable asking for medical care in the future.

I have worked in the medical profession since I was 15. My dad is a doc and he pushed me into nursing.(so why didn't he push me into medicine?) I've worked Peds, ER,OR, OB-GYN and Psych. Nothing you have written surprises me, however I do get a kick out of your humor. Being a patient, however, on the other side of the coin,is complete humility at it's best. Me, the 30 something, attractive female, surrounded by goodlooking med student, residents and the cheif resident at 0600 after a very painful double hernia repair....looking like shit, feeling like shit and then....you all want to see the wound!!!! and press as hard as you can so that I scream and wake up the entire hospital.I understand you all have to learn, but I, personally have HAD IT with teaching hospitals.The blatent disrespect for patients, nurses,secretaries,x-ray techs, and any other tech, janitors and so on is so disgusting, I left the medical field altogether. I miss it, but now I help people with their REAL dreams....buying a house. Real Estate is a lot like medicine, putting your trust in somebody with your body and most of your money!!Surgeons are the worst offenders, any kind of surgeon, even general, but guess what....they put their pants on like everyone else. They are NOT god, like they pretend to be. The lay population needs to STOP putting these already arogant punks on a pedistal.

Doctor Doctor......Just thought id leave a quick note to say how much i enjoyed your blog x ..since you mentioned Breasts (a favourite subject of mine too.....and I can gladly reveal that, yes, I am a Pervert) Id like to mention quite proudly that theres no chance of any growing things...as mine are quite small, and there doesnt seem to be much room for any Sag.....at least not until im 75... I'm also hoping to be Shot before then. Yes, a proud owner of Small breasts....it always worried me how much they could hurt as you run up stairs and stuff (I'll leave the 'stuff' to your imagination). ....anyway, bye for now.....just off to stroke my amazing breasts in appreciation of their wonder.....

Not that you'll read this at this late date... but I'm a medical editor, and the mention of rectal prolapse made me think immediately of this terrible table I had to edit for something. The variables were: pelvic organ prolapse, shower seat slats, and "accidents" involving both. The P values were less than .00000000000000000000005 or something. I feel lucky to have stumbled on such rare statistics. Also, this blog. Smart, interesting. F-ing hilarious.

Basically, you sound perverted. Most people might learn more about medicine by watching TV commercials for rot-butt than by reading you. You seem to have a fetish for self-absorption. Good luck with your fraud career - no doubt you will need it.

Yup, I know excactly how you feel. I gained a perverse respect for anal anatomy, and enjoyed trying out my knowledge on my female roomate (nursing student). When I showed up with the anoscope, she was pretty game to try it. I remember every single time I scope someone in the clinic today. BTW I have a pic of her with the scope but I don't know how to load it onto your blog, just for your own education of course.

Hi again,I see I've been deleted - I'm disappointed that you don't want anything but flattering and cutsey responses and that you can't let a serious and slightly critical response stand. Doctors are dealing with lives and need to be able to handle that sort of thing:)

To Ms. Tate-I searched my inbox (where all the comments go) to see if you were there...and I didn't see anything and am not sure which comment you are referring to (your other one on the most recent post is still there). I apologize if you have been deleted, but if that occurred it was completely accidental. Please feel free to re-post whatever you'd written previously.the fake doc

i realize this is all old news as it were, but as a small-breasted newcomer to this blog i felt compelled to contribute. the other wonderful thing about having small breasts, besides a- men don't stare at you or have conversations with your boobs (except the rare, really desperate or desperately breast-obsessed loser) b- clothes usually fit, and you don't even have to fool with shopping for or even wearing bras if you don't want to is C- they are highly sensitive. i haven't discussed this with other small or large breasted women to confirm, but it is my personal experience that small breasts are the ultimate errogenous zone, while larger breasts may be significantly less sensitive. this has presented me with a few, hem, uncomfortable situations during breast exams, but that is a small price to pay. i leave you to ponder this.

wow I didn't know amything about this, but how the clinics can work like this... pss I'm paying for a service... and they just don't care for almost all doctors medicine it's just another job, like anyone... and the gynecologist just want to see breast and vaginas... come on that's a little pervert :SNice post, thanks for the information.